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Just what is undetectable PSA?
  1. #1
    [email protected] Guest

    Default Just what is undetectable PSA?

    At hubby's last check up (6 mos. after completion of salvage radiation
    after RRP), the doc said his PSA was "zero", yet the actual number was
    ..02.

    Just what does does undetectable or zero PSA mean? I would think if
    any number at all shows up in the PSA test, that that is bad news.

    Thanks.

    Linda
    PA


  2. #2
    Steve Jordan Guest

    Default Re: Just what is undetectable PSA?

    On November 7, Linda wrote:
    > At hubby's last check up (6 mos. after completion of salvage radiation
    > after RRP), the doc said his PSA was "zero", yet the actual number was
    > .02.
    >

    A PSA test result that is =/< 0.05 ng/mL is "undetectable" and is a
    desirable result. See, _A Primer on Prostate Cancer_ 2nd ed. by med onc
    and PCa specialist Stephen B. Strum, MD, and PCa warrior Donna Pogliano
    at page 144.
    > Just what does does undetectable or zero PSA mean? I would think if
    > any number at all shows up in the PSA test, that that is bad news.
    >

    Small amounts of PSA are expressed elsewhere than the prostate. That is
    why ADT often includes meds that block the binding to PSA receptors of
    PSA from such sources.

    Regards,

    Steve J



  3. #3
    Justin Case Guest

    Default Re: Just what is undetectable PSA?


    <[email protected]> wrote in message
    news:[email protected] oups.com...
    : At hubby's last check up (6 mos. after completion of salvage radiation
    : after RRP), the doc said his PSA was "zero", yet the actual number was
    : .02.
    :
    : Just what does does undetectable or zero PSA mean? I would think if
    : any number at all shows up in the PSA test, that that is bad news.
    :
    : Thanks.
    :
    : Linda
    : PA
    :
    My understanding, Linda, is that the urologist has in mind a certain PSA
    level that he or she believes is unlikely to be a problem. Part of it is
    that PSA numbers are subject to a certain fluctuation from time to time,
    depending on many variables. The "best" determination is a trend or average
    as observed for months or, in the early cases, a few years. Laboratory
    equipment itself and the degree of effort that lab technicians or doctors
    require from a test may be significant. I don't know, but I imagine a PSA
    figure that goes to two or more decimal places is more complex and more
    expensive than one at only one decimal place. The figure gives the patient
    an idea that his test is somehow more or less precise and hence more or less
    accurate than one reported at <0.1 or 0.0. In my own case, my reports,
    taken at 9-month intervals now, come back as "undetectable." I know that
    doesn't mean 0.0000, but it means a satisfactorily low value and neither my
    oncologist-surgeon nor myself are concerned; in fact, we are both highly
    encouraged (after about four years).

    Far more important today is the rate of rising PSA. There's an interesting
    article in the Wall Street Journal today that mentions that. So that you
    won't think I'm making this up, I quote from the WSJ, quoting, in turn, from
    Dr.H. Ballentine Carter, professor of urology/oncology at John Hopkins: "A
    50-year-old man with a PSA of 4 will likely be told that he needs a biopsy.
    However, if that man at the age of 40 had a PSA of 2, the 10-year trend
    suggests that he likely doesn't have cancer or at least not an aggressive ca
    ncer."

    In short, Dr. Carter advises that a man with a score above 0.6 at age 40
    should be checked every two or three years. The figures obtained in this
    way are indicative of the rate of increase and level of concern. The data
    show that a man whose PSA rises by 0.35 ng/ml or more each year will see a
    fivefold increase in the risk of dying from prostate cancer in the next two
    to three decades.

    There's more, but I've already answered questions that you hadn't asked.
    Watch this thread for more informative replies.

    Ken Bland



  4. #4
    Leonard Evens Guest

    Default Re: Just what is undetectable PSA?

    [email protected] wrote:
    > At hubby's last check up (6 mos. after completion of salvage radiation
    > after RRP), the doc said his PSA was "zero", yet the actual number was
    > .02.
    >
    > Just what does does undetectable or zero PSA mean? I would think if
    > any number at all shows up in the PSA test, that that is bad news.


    The test isn't perfect and there is some measurment error. So they
    can't really confirm a measurement of zero. In addition, there are
    other tissues in the body which produce very small amounts of PSA.

    There is also sometimes confusion in that the actual result is 'less
    than 0.02' and this is reported as 0.02.

    In any case, such a value means that PSA is undetectable for all
    practical purposes, so you shouldn't worry about it.

    >
    > Thanks.
    >
    > Linda
    > PA
    >


  5. #5
    Bill Guest

    Default Re: Just what is undetectable PSA?

    Ken, she is talking about PSA post-primary Tx while you are talking
    about pre-Dx PSAV. "Undetectable" certainly does not mean some
    arbitrary number that the uro has in mind for a good result or a
    do-nothing scenario, and I don't think the ultrasensitive test costs
    any more (or at least not enough more to be a barrier) than the
    standard one. "Undetectable" mean the level below the sensitivity/low
    threshold of the test being used. The old standard test could not
    measure below .1 so .1 was considered "undetectable" because it
    literally was. But is was never the same a zero. Now we have tests that
    go to even 3 digits so the old .1 is really out the window. As others
    have pointed out, the consensus now is apparently .05. While numbers
    that low may not have immediate impact on Tx decisions, it may well
    have Dx value down the road.

    Bill Denton
    RP 2/12/02
    PSA 1.10
    Memphis


  6. #6
    MAS Guest

    Default Re: Just what is undetectable PSA?

    Just thought that I would weigh in. Undetectable PSA varies with the doctor
    and in how it is used. For example on each of the following PSA tests I was
    told at some point that it was undetectable:

    0.2
    0.1
    less than 0.1

    A lot has to do with the manufacture of the antigen elsewhere in the body
    not associated with the prostate.

    I realize that this will drive some batty, but so be it.


    <[email protected]> wrote in message
    news:[email protected] oups.com...
    > At hubby's last check up (6 mos. after completion of salvage radiation
    > after RRP), the doc said his PSA was "zero", yet the actual number was
    > .02.
    >
    > Just what does does undetectable or zero PSA mean? I would think if
    > any number at all shows up in the PSA test, that that is bad news.
    >
    > Thanks.
    >
    > Linda
    > PA
    >




  7. #7
    Steve Kramer Guest

    Default Re: Just what is undetectable PSA?



    <[email protected]> wrote in message
    news:[email protected] oups.com...
    > At hubby's last check up (6 mos. after completion of salvage radiation
    > after RRP), the doc said his PSA was "zero", yet the actual number was
    > .02.


    That's great!!! Especially more than a year after RT.


    --
    PSA 16 10/17/2000 @ 46
    Biopsy 11/01/2000 G7 (3+4), T2c
    RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
    PSA .1 .1 .1 .27 .37 .75
    EBRT 05-07/2002 @ 47
    PSA .34 .22 .15 .21 .32
    Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05,
    2/06, 6/06
    PSA .07 .05 .06 .09 .08 .132 .145
    Casodex added daily 07/06
    PSA <0.04
    Non Illegitimi Carborundum



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